Approximately one in nine adults, or 20 million Americans have chronic kidney disease with another 20 million at increased risks. There are around 16,000 dialysis patients in Georgia, according to the U.S. Renal Data System, USRDS 2009 Annual Data Report.
"One of the major challenges that people experience when they first start dialysis is that they have a lot of foods in their diet that they can no longer have," Nesbitt Gignilliat, RD, LD, dietitian at Fresenius Medical Care said. "All of the sudden they have a lot of restrictions, especially in the South where we have a lot of common foods that are higher in phosphorus."
Reducing phosphorus in a diet can be particularly difficult. While dialysis patients are given lists of food to avoid, food to limit and food that is okay, many things are prepackaged, such as fast-food.
"A lot of people forget that additives in there will increase phosphorus content," Gignilliat noted. "Unfortunately, phosphorus is not required on labels, and a lot of people are overlooking labels. They don't take the time to read. They see something is okay on the list, but if the food is prepackaged it's different."
Gignilliat stressed that something may "seem low in phosphorus, but it may have additives."
Gignilliat also noted that it can become difficult to replace or find an alternative that satisfies patients.
While patients are given lists of foods to avoid, Gignilliat pointed out that a responsible diet isn't only about eliminating certain foods from your menu.
"Sometimes it's just about limiting how much of something you have," she said. "A lot of times it's trying to find something else to eat instead of just completely avoiding a food."
For a red sauce, such as a spaghetti sauce, Gignilliat said it is often okay to have some if the amount is limited to about a third of cup. However, there are alternatives. Olive oil infused with garlic or a butter sauce can be a healthy and tasty substitute to tomato sauces.
You can also maintain variety and flavor in your diet and enjoy life by substituting a hard cheese, such as in macroni and cheese, with a ricotta cheese/parmesan mixture.
Gignilliat works as part of a team with social workers, a clinical staff, nurses, etc. As a dietitian, she meets with patients when they start treatment and ensures that they are familiar with the renal diet and how it coincides with their own personal diet. Gignilliat follows up with patients and makes sure that they are staying on track with their diet, medications and fluids. If patients need help with meal plans, Gignilliat provides assistance.
Gignilliat stressed that patients must becomes experts on their diets and be aware of why it's important to follow a restricted diet and the possible damage that can be done by not eating correctly.
"Stay in touch with your medical team to know what's going on with lab work," Gignilliat said. "If you have questions and aren't clear on something, talk with your dietitian, doctor, nurse, whoever the question is related to, and definitely talk with your dietitian because he or she can give you ideas to get out of the box and get you out of your routine or what you are use to eating."
Fresenius Medical Care North America and Chef Aaron McCargo, Jr., star of Food Network’s Big Daddy’s House, partnered to develop tasty, satisfying and new dialysis-friendly recipes as part of FMCNA’s Healthy Lifestyle initiative aimed at helping people with chronic kidney disease live a better life on dialysis.
Take a look at some of the recipes created by Fresenius Medical Care and Chef McCargo:
More recipes are available at www.ultracare-dialysis.com.